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. 2020 Jul 18;10(7):492.
doi: 10.3390/diagnostics10070492.

Radiomics for Tumor Characterization in Breast Cancer Patients: A Feasibility Study Comparing Contrast-Enhanced Mammography and Magnetic Resonance Imaging

Maria Adele Marino  1   2 , Doris Leithner  1   3 , Janice Sung  1 , Daly Avendano  1   4 , Elizabeth A Morris  1 , Katja Pinker  1   5 , Maxine S Jochelson  1
Affiliations

Radiomics for Tumor Characterization in Breast Cancer Patients: A Feasibility Study Comparing Contrast-Enhanced Mammography and Magnetic Resonance Imaging

Maria Adele Marino et al. Diagnostics (Basel). .

Abstract

The aim of our intra-individual comparison study was to investigate and compare the potential of radiomics analysis of contrast-enhanced mammography (CEM) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast for the non-invasive assessment of tumor invasiveness, hormone receptor status, and tumor grade in patients with primary breast cancer. This retrospective study included 48 female patients with 49 biopsy-proven breast cancers who underwent pretreatment breast CEM and MRI. Radiomics analysis was performed by using MaZda software. Radiomics parameters were correlated with tumor histology (invasive vs. non-invasive), hormonal status (HR+ vs. HR-), and grading (low grade G1 + G2 vs. high grade G3). CEM radiomics analysis yielded classification accuracies of up to 92% for invasive vs. non-invasive breast cancers, 95.6% for HR+ vs. HR- breast cancers, and 77.8% for G1 + G2 vs. G3 invasive cancers. MRI radiomics analysis yielded classification accuracies of up to 90% for invasive vs. non-invasive breast cancers, 82.6% for HR+ vs. HR- breast cancers, and 77.8% for G1+G2 vs. G3 cancers. Preliminary results indicate a potential of both radiomics analysis of DCE-MRI and CEM for non-invasive assessment of tumor-invasiveness, hormone receptor status, and tumor grade. CEM may serve as an alternative to MRI if MRI is not available or contraindicated.

Keywords: breast cancer; characterization; contrast-enhanced mammography; diagnosis; magnetic resonance imaging; prognosis; radiomics; texture analysis.

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Conflict of interest statement

Daly Avendano received travel/accommodations/meeting expenses from BD (BARD) for an interventional masterclass in London. Elizabeth A. Morris has received a grant from GRAIL Inc. for research not related to the present article. Janice S. Sung has received research grants from Hologic and GE. Katja Pinker received payment for activities not related to the present article including lectures and service on speakers’ bureaus and for travel/accommodations/meeting expenses unrelated to activities listed from the European Society of Breast Imaging (MRI educational course, annual scientific meeting), the IDKD 2019 (educational course), and Siemens Healthineers. Maxine S. Jochelson has received an honorarium from GE for speaking and an honorarium for speaking at the Lynn Sage Breast Cancer Symposium and at MD Anderson. The remaining authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Details of lesions characteristics stratified by invasiveness, hormonal status, and grading. Abbreviations: CEM, contrast-enhanced mammography; MRI, magnetic resonance imaging; HR, hormone receptor; G1, Grade 1; G2, Grade 2; G3, Grade 3.
Figure 2
Figure 2
Palpable left abnormality in a 44-year-old patient. (A) Digital mammography and (B) contrast-enhanced mammography of the left breast, mediolateral-oblique view. (A,B) The breast shows scattered fibroglandular tissue. Minimal background parenchymal enhancement is present. In the left upper-outer quadrant, there are multiple masses with associated focal asymmetry and suspicious enhancement extending anteriorly toward the nipple (red arrows). (C) Sagittal fat-suppressed T1-weighted image acquired after the administration of intravenous gadolinium (2 min) twelve days after the contrast-enhanced mammography examination. There is abnormal enhancement extending from the 12/1 o’clock axis posteriorly to the nipple, with multiple areas of enhancement (red arrow). Pathology results yielded invasive triple-negative ductal carcinoma, with positive axillary lymph-nodes.
Figure 3
Figure 3
A 42-year old women with a biopsy-proven invasive ductal carcinoma (G3, HR positive, HER2 negative) in the right retro-areolar space. (A) Contrast-enhanced mammography shows, on the right, a 22 mm rounded area of enhancement. The lesion was manually segmented (2D yellow region of interest), and the clip marker had to be included in the segmented area. (B) Sagittal fat-saturated post-contrast enhanced T1-weighted image. The breast is heterogeneously dense with moderate background enhancement. In the retroareolar right breast, there is a 22 mm spiculated mass containing a localizing clip from biopsy. The mass is inseparable from the nipple, which appears slightly retracted, and there is associated skin thickening. The lesion was manually segmented (2D red region of interest).
See this image and copyright information in PMC

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